Association of Anemia with Outcomes of Acute Heart Failure

Objectives: Anemia is common in patients presenting with acute congestive heart failure (CHF); when hemoglobin (HGB) declines to low levels, it can result in worse outcomes. The aim of this study was to determine a level of HGB on admission or discharge that affects outcomes in patients with CHF and then to evaluate the effect of the low HGB levels on these outcomes. Methods: We conducted a retrospective cohort study of 756 patients admitted...

Vision Screening in Adults Across the Life Span

Vision screening is quick, inexpensive, and easily performed by ancillary staff, and it may provide the physician with useful additional information for treatment...

History of Music Therapy and Its Contemporary Applications in Cardiovascular Diseases

Contrary to what is commonly believed, music therapy is an old cure, the use of which is lost in the mists of time. Music always has been perceived to have particular healing powers, and the entire history of civilization contains aspects that link music to physical and mental healing. It seems that the adoption of music for therapeutic purposes harks back to a distant past, probably since the Paleolithic period: it was believed that listening...

Measuring Adherence to Hepatitis C Direct-Acting Antiviral Medications: Using the VAS in an HCV Treatment Clinic

Objectives: To implement the widespread treatment of hepatitis C virus (HCV), validated self-report measures to assess medication adherence are needed for monitoring patients who are prescribed HCV direct-acting antivirals (DAAs). The Visual Analog Scale (VAS) is an efficient and well-validated tool for measuring adherence to antiretrovirals in human immunodeficiency virus populations. This study compared VAS scores with pill counts and serum...

Eradication Rate of Helicobacter pylori on the US–Mexico Border Using the Urea Breath Test

Objectives: Helicobacter pylori is prevalent worldwide, especially in Latin America. Triple and quadruple antibiotic therapies have been relatively effective; however, resistance has emerged in recent years. The treatment success rate of these regimens on the border of the United States and Mexico is unknown. Our study attempted to determine eradication rates of two major regimens based on urea breath test (UBT) results in patients previously...

A Brief Drug Class Review: Considerations for Statin Use, Toxicity, and Drug Interactions

Abstract: For approximately 30 years, statins have been effectively used to control cholesterol, thereby reducing the morbidity and mortality associated with cardiovascular disease. Evidence-based recommendations regarding how these drugs are dosed and used have changed significantly through the years. There are seven statins approved for use in the United States, and although the mechanism of action pertaining to cholesterol reduction is the...

E-Cigarette Toxicity?

Abstract: Tobacco smoking is the most preventable cause of morbidity and mortality. In just a few short years, electronic cigarettes (e-cigarettes) have become increasingly popular, especially for younger individuals. Many people believe that e-cigarettes are safe. The inhaled aerosols of e-cigarettes contain numerous potential toxicities, some of which could be dangerous for health with long-term use. The safety of prolonged aerosol exposure is...

Development of Multiple Primary Cancers in Lung Cancer Patients: Appalachian Versus Non-Appalachian Populations of Kentucky

Objectives: The aim of this study was to investigate whether patients with lung cancer in Appalachian Kentucky are more likely to develop multiple primary cancers than patients in non-Appalachian Kentucky. Additional analyses were conducted to identify other factors that may be associated with an increased hazard of developing multiple primary cancers in patients with lung cancer. Methods: The data for this retrospective, population-based...

Radiologists’ Recommendations for Additional Imaging on Inpatient CT Studies: Do Referring Physicians Follow Them?

Objectives: Studies have found that recommendations for additional imaging (RAI) accompany up to 31% of index computed tomography (CT) scans. In this study we assessed the frequency with which recommendations are accepted by the referring physician and the impact of AI on case management. Methods: We performed a cross-sectional study of all index CT scans of the chest, abdomen, and pelvis performed on adult inpatients during a 1-month period...

Authors’ Response

To the Editor: The authors thank Dr Madias for his interest in our work. We discussed the possibility of takotsubo cardiomyopathy (TTC) and reverse TTC (rTTC) being a transient evolution of the same disease, given multiple reports in the literature of patients displaying temporal changes of akinetic areas during TTC with varying timelines....

Red Cell Width: An Emerging and Novel Biomarker of Systemic Inflammation

To the Editor: Systemic inflammation has been implicated in the etiology of many diseases and is often linked to poor health outcomes. Several indices have been used as markers for such inflammation....

Using Pill Identification Calls to Poison Centers as a Marker of Drug Abuse at Three Texas Military Bases

Objectives: Opioid abuse is a growing problem in civilian communities, and it has developed in the military as well. Telephone calls to poison centers requesting pill identification (ID) is a marker of drug abuse. This study identifies the number of pill ID calls made to the poison centers from areas containing and surrounding three Texas military bases during an 8-year period. Methods: We performed a retrospective observational study...

Utility of the Shock Index for Risk Stratification in Patients with Acute Upper Gastrointestinal Bleeding

Objectives: Patients with upper gastrointestinal bleeding (UGIB) frequently require hospitalization, and a small but significant percentage of these patients have adverse outcomes. Risk-scoring tools can help clinicians organize care and make predictions about outcomes. The shock index (heart rate divided by systolic blood pressure) has been used in multiple acute disorders and has the potential to identify patients with UGIB who are at risk for...

Acute Pancreatitis: Etiology, Pathology, Diagnosis, and Treatment

Acute pancreatitis is a fascinating disease. In the United States, the two most common etiologies of acute pancreatitis are gallstones and excessive alcohol consumption. The diagnosis of acute pancreatitis is made with a combination of history, physical examination, computed tomography scan, and laboratory evaluation. Differentiating patients who will have a benign course of their pancreatitis from patients who will have severe...

On “Why Is Reverse Takotsubo ‘Reverse’?”

To the Editor: I enjoyed reading the article by Rosu et al about the reverse (ie, inverse) variant (ie, hypocontractile base-ventricular segment and a hypercontractile apex) of takotsubo cardiomyopathy (rTTC) that appeared in the May 2017 issue of the Southern Medical Journal....

Subclinical Atherosclerosis Among Young and Middle-Aged Adults Using Carotid Intima-Media Thickness Measurements

Objectives: The presence of atherosclerotic plaque in the carotid arteries is a strong predictor of cardiovascular disease (CVD). Research and data on CVD risk have been derived primarily from individuals aged 55 years or older, and assessment of CVD risk among young and middle-aged adults seldom has been studied. The use of ultrasonography to measure carotid intima-media thickness (IMT) and carotid plaque appears to have utility to detect...

Commentary on “Using Pill Identification Calls to Poison Centers as a Marker of Drug Abuse at Three Texas Military Bases”

The opioid epidemic in the United States is fueled by both prescription medications and illicitly manufactured drugs. Individuals who purchase or obtain prescription opioids illegitimately may wish to confirm the authenticity of the pills. For those involved with regional poison center operations, it comes as no surprise that the public will call in to identify their...

Hospital Discharge Disposition of Stroke Patients in Tennessee

Objectives: Early determination of hospital discharge disposition status at an acute admission is extremely important for stroke management and the eventual outcomes of patients with stroke. We investigated the hospital discharge disposition of patients with stroke residing in Tennessee and developed a predictive tool for clinical adoption. Our investigational aims were to evaluate the association of selected patient characteristics with...

Management of Metastatic Spinal Cord Compression

Cancer metastasis is a key event in tumor progression associated not only with mortality but also significant morbidity. Metastatic disease can promote end-organ dysfunction and even failure through mass effect compression of various vital organs including the spinal cord. In such cases, prompt medical attention is needed to restore neurological function, relieve pain, and prevent permanent damage. The three therapeutic approaches to managing...

Commentary on “Hospital Discharge Disposition of Stroke Patients in the State of Tennessee”

In this issue of the Southern Medical Journal, Cho and colleagues assessed the hospital discharge location for patients with stroke and attempted to develop a tool to help determine the discharge location early in the clinical course.1 The treatment for acute ischemic stroke has come a long way since the approval of intravenous tissue plasminogen activator in 1995 to the advent and use of stent retrievers and large-bore aspiration catheters in...